Masud Hasan, Yadav Prashant, Yadav Sushmita, Kamal Mohammed
Department of Orthopedics, Sir Salimullah Medical College & Mitford hospital, Dhaka, Bangladesh.
Sir Salimullah Medical College & Mitford hospital, Dhaka, Bangladesh.
Int J Surg Case Rep. 2022 Oct;99:107680. doi: 10.1016/j.ijscr.2022.107680. Epub 2022 Sep 20.
Giant cell tumor (GCT) is a benign bone tumor typically seen in epiphysis or metaphysis of mature long bones. Multiple large multinucleated giant cells dispersed among mononuclear spindle cells and monocytes constitute characteristic histological background of GCT of bone (GCTB).
A 15-year-old girl was admitted to our hospital with the complaint of pain and swelling in the left leg with difficulty in walking for 2 years. On X-ray of the left leg, osteolytic, expansile, eccentric lesion with sclerotic bone margin on the diaphysis of the tibia was seen suggesting oesteofibrous dysplasia. MRI demonstrated findings compatible with adamantinoma. The subsequent histology report was rather surprising, consistent with giant cell tumor of the bone. Extended intralesional curettage was done with the help of a high-speed burr followed by chemical cauterization and bone grafting. The patient was followed up for 2 years. The patient could walk normally without assistance or any signs of a recurrence.
GCTB commonly affects people in their third and fourth decades of life and involves epiphysis of the long bone, but this is a case of diaphyseal GCT, at an age of 15 years. It is challenging to diagnose GCT, if present in an unusual location, unless confirmed by histopathological examinations.
A multi-disciplinary approach is required to correctly reach the diagnosis of GCT when it happens to be in an uncommon location(s). Early diagnosis with appropriate treatment and long-term follow-up is mandatory for the successful outcome of the treatment.
骨巨细胞瘤（GCT）是一种良性骨肿瘤，通常见于成熟长骨的骨骺或干骺端。多个大的多核巨细胞分散于单核梭形细胞和单核细胞之间，构成了骨巨细胞瘤（GCTB）的特征性组织学背景。
一名15岁女孩因左腿疼痛、肿胀伴行走困难2年入院。左腿X线检查显示，胫骨骨干有溶骨性、膨胀性、偏心性病变，骨边缘硬化，提示骨纤维发育不良。磁共振成像（MRI）显示的结果与成釉细胞瘤相符。随后的组织学报告相当令人惊讶，结果符合骨巨细胞瘤。在高速磨钻的辅助下进行了扩大的病灶内刮除术，随后进行化学烧灼和骨移植。对该患者进行了2年的随访。患者能够正常行走，无需辅助，也没有任何复发迹象。
GCTB通常影响三四十岁的人群，累及长骨骨骺，但这是一例15岁的骨干GCT病例。如果GCT位于不寻常的部位，除非经组织病理学检查证实，否则诊断具有挑战性。
当GCT位于不常见部位时，需要采用多学科方法才能正确诊断。为使治疗取得成功，必须进行早期诊断、给予适当治疗并进行长期随访。
